Generally, follow-up for patients suffering from chronic medical conditions, such as congestive heart failure or respiratory insufficiency, occurs in-clinic once every three to twelve months, or as necessary. Although mandatory, the clinic visits are also often the only one-on-one interpersonal contact that occurs between the patient and his or her physician or healthcare provider, absent complications or other health-related issues. In-clinic visits allow a clinician to manage those patient medical devices and sensors that may require specific attention, for example, implantable medical devices (IMDs), such as pacemakers or defibrillators, or home-based sensors, such as Holter monitors, although certain patient medical devices and sensors, such as scales and blood pressure cuffs, seldom require clinical follow-up. Where appropriate, devices and sensors are interrogated using a conventional programmer, which retrieves stored event data and device settings and allows reprogramming to modify or upgrade operational behaviors. However, due to limited onboard storage, the patient data received through in-clinic interrogations from the devices and sensors is limited in quantity and represents a “snapshot” of patient wellness, frequently far removed in time from the occurrence of an event of potential medical interest.
Alternative follow-up methods, such as transtelephonic monitoring, can enable a healthcare provider to provide limited remote patient management on a more frequent, often monthly, basis. In addition, dedicated remote patient management devices, such as repeaters, have enabled healthcare providers to remotely perform follow-up monitoring on a daily basis using a data communications network, such as the Internet. Nevertheless, these devices require patients to remember to initiate remote sessions and impose the need to confirm patient data receipt on the clinician. Additionally, substantially all received patient data must be reviewed by a clinician to ensure prudent health care provisioning, which frequently requires specific clinical expertise as a service separate from a general clinical practice.
Therefore, there is a need for an approach to providing automated patient management of remote patients through highly configurable patient data collection and evaluation and alert notification. Preferably, such an approach would relieve clinicians from the drudgery of confirming patient compliance and the routine review of detectable non-critical conditions.